576 MORBID ANATOMY.
The whole of the right side was tender and tympanitic. Constitutional symptoms grave. One pint of fetid pus was drawn off from the left ovary on the 22d ; three and a half pints from the right on the 24th ; and on the even- ing of that day she died.
Pus, with recent lymph, was found in both cysts. 1862.
Dr. H. J. Bigelow.
2718. An ovarian cyst, that was supposed to have ruptured several times, and at last filled the peritoneal cavity with a secretion from its inner surface.
The patient was unmarried, fifty-four years of age, and had always been quite healthy, though of very sedentary hab- its. About five years before death the catamenia ceased, and she very soon afterward had the first of several attacks which were thought to warramt the above diagnosis. A rounded, hard, smooth tumor would appear in the region of the left ovary, without tenderness or pain, but with a general feeling of indisposition. In the course of a week or two the tumor would suddenly disappear ; a soft, dif- fused swelling across the hypogastric region would follow ; and she would almost at once be seized with universal cramp-like pains and retching. The pains were so severe, that she would sometimes fall upon the floor when the attack came on, but in the course of three or four hours they would subside. The retching would continue for about the same time, but with little or no vomiting, and the hypogastric swelling would gradually subside ; the whole attack lasting from about two to four weeks. At first the tumor was about the size of a small apple, but it . enlarged somewhat with each attack.
About three years before death, having altogether had six or seven attacks, the character of which was very sim- ilar, she had the last, and this was by far the most severe. The tumor enlarged to the size of a pint bowl, and it did not burst for two or three months, but the exact time at which the rupture took place was most satisfactorily indi- cated. She was awakened from her sleep by a sensation as if she had been slapped with the hand upon the tumor, and at once this last disappeared. She then awoke her sister, told her the circumstances, and said that she felt as
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